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General NPI Number Information
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NPI Number | 1871826610
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Entity Type | Individual
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Provider Name | ELIZABETH J MOORE NP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 10967 ALLISONVILLE RD STE 240
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City | FISHERS
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State | IN
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Zip | 46038-2634
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Country | US
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Telephone | 216-468-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2514 OAK PARK COURT
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City | RICHMOND
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State | IN
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Zip | 47374-1282
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Country | US
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Telephone | 774-285-0822
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Fax | 765-966-1293
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 28087121A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 71005185B
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 71005185A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71005185A
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License Number State | IN
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